외상 후 발생한 가성 동맥류 및 만성 혈종에 의한 일측성 요천추 신경총병증 - 증례 보고 -
Unilateral Lumbosacral Plexopathy with Pseudoaneurysm and Intraperitoneal Hematoma Following Trauma - A Case Report -
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This report describes an unusual cause of lumbosacral plexopathy resulting from delayed gluteal artery pseudoaneurysm. We report a 32-year-old male patient who had traumatic brain injury with left iliac bone fracture by motorcycle traffic accident. At initial physical examination, we check grossly the motor grade 4 in both lower extremities at least. After 50 hospital days, he complained severe pain with progressive weakness and hypoesthesia of left lower extremity. Electrodiagnostic study revealed left lumbosacral plexopathy and magnetic resonance imaging of pelvis showed huge hematoma along left iliacus and psoas muscles. Angiography showed a large pseudoaneurysm around bifurcation of superior and inferior gluteal artery. After embolization using coils, the pain was disappeared. We suggest that combined vascular injury or peripheral nerve injury need to be carefully evaluated in patients with multiple trauma.
Abstract
This report describes an unusual cause of lumbosacral plexopathy resulting from delayed gluteal artery pseudoaneurysm. We report a 32-year-old male patient who had traumatic brain injury with left iliac bone fracture by motorcycle traffic accident. At initial physical examination, we check grossly the motor grade 4 in both lower extremities at least. After 50 hospital days, he complained severe pain with progressive weakness and hypoesthesia of left lower extremity. Electrodiagnostic study revealed left lumbosacral plexopathy and magnetic resonance imaging of pelvis showed huge hematoma along left iliacus and psoas muscles. Angiography showed a large pseudoaneurysm around bifurcation of superior and inferior gluteal artery. After embolization using coils, the pain was disappeared. We suggest that combined vascular injury or peripheral nerve injury need to be carefully evaluated in patients with multiple trauma.
참고문헌 (10)
- Planner AC, "Causes of lumbosacral plexopathy", Clin Radiol, 61, pp.987~995 (2006)
- Holting T, "Diagnosis and treatment of retroperitoneal hematoma in multiple trauma patients", Arch Orthop Trauma Surg, 111, pp.323~326 (1992)
- 이수현, "일측성 후복막강 혈종에 의한 양측성 대퇴신경병증 -증례보고-", Annals of Rehabilitation Medicine, 25(1), pp.168~172 (2001), 대한재활의학회
- Dumitru D, "Electrodiagnostic medicine, 2nd ed", pp.837~883 (2002), Hanley & Belfus
- James A, Young, "Pain and traumatic brain injury", Phys Med Rehabil Clin N Am, 18, pp.145~163 (2007)
- 정지영, "장요근 점액낭염으로 인해 발생한 대퇴신경병증 - 증례 보고 -", 대한근전도 전기진단의학회지, 11(1), pp.39~42 (2009), 대한근전도전기진단의학회
- Shin YI, "Unilateral femoral neuropathy secondary to iliacus and psoas hematoma during anticoagulant therapy", J Korean EMG Electrodiagn Med, 3, pp.34~37 (2001)
- Shin YI, "Bilateral sacral plexopathy concomitant with bilateral huge heterotopic ossifications", J Korean EMG Electrodiagn Med, 7, pp.73~77 (2005)
- Aydin A, "Traumatic inferior gluteal artery pseudoaneurysm: case report and review of literature", Am J Emerg Med, 25, pp.488e1-3~ (2007)
- Meltem AM, "Internal iliac artery pseudoaneurysm; An unusual cause of sciatica and lumbosacral plexopathy", Am J Phys Med Rehabil, 87, pp.681~683 (2008)
